Remote Disability Claims Specialist

Pay Rate: $50 per hour
Work Mode: Fully Remote

Summary:

• Part Time
• 20 hours per week
• Availability needed during core workdays and hours: Monday – Friday, 7:00AM – 5:00PM local time
• Must be available to work EST hours during training

Responsibilities:

• Effectively manage an assigned caseload of moderately complex claims with some level of oversight.
• Provide timely, balanced, and accurate claims reviews, documentation, and recommended decisions.
• Communicate proactively with claimants and/or their representatives, demonstrating empathy and active listening.
• Document conversations within claim files in a timely manner with appropriate detail and professional writing skills.
• Interact and communicate effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations.
• Compile file documentation and correspondence requiring extensive policy and factual detail.
• Collaborate with external and internal resources to gather necessary data for claim evaluations.
• Clarify and reconcile inconsistencies during claim evaluations and collaborate with Fraud Waste and Abuse resources as needed.
• Calculate monthly benefits due after elimination period, including Client, Social Security Offsets, and Rehab Return to Work benefits.
• Provide timely and detailed written communication during the claim evaluation process.
• Address and resolve escalated customer complaints in a timely and thorough manner.

Requirements:

• Minimum 3 years of LTD/IDI Insurance Claims experience.
• Experience with independent judgment and decision-making based on available facts.
• Demonstrated use of critical thinking and analysis when reviewing information.
• Creative problem-solving abilities and the ability to think outside the box.
• Excellent interpersonal and communication skills in both verbal and written form.
• Excellent customer service skills proven through internal and external customer interactions.
• Demonstrated conceptual thinking, risk management, and ability to handle complex situations effectively.
• Organizational and time management skills.
• Bachelor’s degree.